Improving care and support for children and young people with mental health problems

Three Royal Colleges have jointly agreed five shared principles designed to improve care and support for children and young people with mental health problems.

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The Royal College of General Practitioners, The Royal College of Paediatrics and Child Health and The Royal College of Psychiatrists have issued a position statement saying that as well as the commissioning of specialist treatment, an effective child and young people’s (CYP) mental health system required:

  • acknowledgment that CYP mental health is everybody’s business and should be supported by a shared vision for CYP mental health across all government departments
  • a preventative, multi-agency approach to mental health across all ages, incorporating attention to education for young people and families, social determinants, and health promotion
  • a system of national and local accountability for population-level CYP mental health and well-being, delivered via integrated local area systems
  • training and education for the whole children’s workforce in their role and responsibilities for CYP mental health
  • more support, both from specialist services and other sectors, for professionals dealing with CYP who do not meet referral threshold to CAMHS.

Full document: Position statement on children and young peoples’ mental health

Substance misuse in older people

Action is needed to deal with growing levels of substance misuse in people aged over 50, claims BMJ editorial 

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Researchers in the UK and Australia said the number of people aged over 50 who were experiencing problems from substance misuse was growing rapidly and the numbers receiving treatment were expected to treble in the US and double in Europe by 2020.

In both the UK and Australia, dangerous levels of drinking are declining, except among people aged 50 years and older, they said. One of the authors warns that the issue goes beyond drinking, citing illicit drugs such as cannabis, and commonly prescribed medications such as opioid painkillers as also being an issue.

Full  editorial:  Rao, R. & Roche, A.  Substance misuse in older people: Baby boomers are the population at highest risk  BMJ 2017;358:j3885

Related : Baby boomers’ drink and drug misuse needs urgent action, warn experts | The Guardian

Protecting children from tobacco

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The World Health Organization European Region has published Tobacco-free generations: protecting children from tobacco in the WHO European Region.

This report highlights ongoing and emerging tobacco-related issues that affect children in Europe and examines the regulatory frameworks, commitments and other tools that countries should use to protect children from tobacco. This also includes more novel approaches that could be used to pave the way towards a tobacco-free European Region.

Breastfeeding: five ways it can be encouraged responsibly

Our behaviour is driven by the environment in which we live: public attitudes, financial constraints, and support from others all affect our confidence and ability to act | The Conversation

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Despite increasing breastfeeding rates being a strategic priority globally, the involvement of many governments often only goes so far as unhelpful messages extolling women to breastfeed. These don’t work because they don’t change the environment in which women are trying to breastfeed. They might tell women breastfeeding is important but they don’t offer practical support, change negative public attitudes, or help women delay going back to work. All of this pushes many women to stop breastfeeding before they are ready.

Rather than focusing on telling women to breastfeed, governments must recognise their wider public health responsibility, and work to create an environment that actually supports breastfeeding. It shouldn’t be left to charities and volunteers alone. Support should be part and parcel of society – and implementing a new strategy is not as difficult as you might think.

Read the full blog post here

Effectiveness of dementia risk reduction messaging in NHS health checks.

NHS health check 40-64 dementia pilot research findings | Alzheimer’s Society

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The NHS Health Check programme is a statutory public health intervention commissioned by all local authorities in England. It aims to improve the health and wellbeing of adults aged 40-74 years through the promotion of earlier awareness, assessment, and management of the major risks factors and conditions driving premature death, disability and health inequalities in England.

The overall aim of the research was to evaluate the pilot and assess the feasibility of extending the NHS Health Check for 40-64 year olds to include a dementia risk reduction component. Specific objectives of the research included first, to understand the impact of the NHS Health Check on an individual’s knowledge and awareness of dementia risk reduction and the impact of the intervention on individuals’ intention to change behaviour.

The second objective was to identify (where sample sizes allowed) whether any differences in the delivery of the intervention between pilot sites had any effect on individual’s awareness and understanding of dementia risk reduction.

The third objective was to understand professional awareness and confidence in promoting dementia risk reduction messages and to identify further training requirements, resources and support.

The final objective was to assess any implications for services and commissioners and provide PHE with advice on any further longer-term evaluation that will be required.

Full report here

Is use of the internet in midlife associated with lower dementia incidence?

Study suggests that use of internet by individuals aged 50 years or older is associated with a reduced risk of dementia

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Objectives: Dementia is expected to affect one million individuals in the United Kingdom by 2025; its prodromal phase may start decades before its clinical onset. The aim of this study is to investigate whether use of internet from 50 years of age is associated with a lower incidence of dementia over a ten-year follow-up.

Methods: We analysed data based on 8,238 dementia free (at baseline in 2002–2004) core participants from the English Longitudinal Study of Ageing. Information on baseline use of internet was obtained through questionnaires; dementia casesness was based on participant (or informant) reported physician diagnosed dementia or overall score on the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE). Cox proportional hazards regression analysis was used for examining the relationship between internet use and incident dementia.

Results: There were 301 (5.01%) incident dementia cases during the follow-up. After full multivariable adjustment for potential confounding factors, baseline internet use was associated with a 40% reduction in dementia risk assessed between 2006–2012 (HR = 0.60 CI: 0.42–0.85; p < 0.05).

Conclusion: This study suggests that use of internet by individuals aged 50 years or older is associated with a reduced risk of dementia. Additional studies are needed to better understand the potential causal mechanisms underlying this association.

Full reference: Eleonora d’Orsi, et al.  Is use of the internet in midlife associated with lower dementia incidence? Results from the English Longitudinal Study of Ageing
Aging and Mental Health |Published online: 10 Aug 2017

Improving health outcomes for young people

Habits and behaviours which develop between the ages of 10 to 25 can help determine what sort of life people have and the person they become. In terms of health,  physical activity levels can start declining rapidly during these years, while many teenagers find it difficult to stick to a healthy diet. Mental health problems can also start to develop. By the age of 14, half of all lifetime cases of psychiatric disorders will have started and by 24 three quarters will.

The case studies in this report set out different approaches to supporting the health of young people. Each case study provides an opportunity to reflect on what made the initiative a success and how this learning can be adapted to work in other areas.

Full document: Partnership approaches to improving health outcomes for young people